How we may use and disclose your health information
Kutsy's Medical Practice creates and keeps records of the care and services you receive. This record is used to plan your care, as a means of communication among the health professionals who contribute to your care, and as a basis for billing. Your health information may be used and disclosed for the following purposes without additional written authorization:
- Treatment. Information may be shared among clinicians and staff involved in your care, and with other providers involved in your treatment, such as specialists you are referred to.
- Payment. Information may be used and disclosed to bill and collect payment from you, an insurance company, or a third party for services provided.
- Healthcare operations. Information may be used for activities such as quality review, staff training, licensing, and other operations needed to run the practice.
Certain other uses and disclosures do not require your authorization, including disclosures required by law, for public health activities, to avert a serious threat to health or safety, and in response to a valid court order or subpoena. Any use or disclosure not described in this notice will be made only with your written authorization, which you may revoke at any time.
Your rights regarding your health information
- Right to access. You may ask to inspect and receive a copy of your medical and billing records, with limited exceptions.
- Right to request amendment. You may ask us to amend your health information if you believe it is incorrect or incomplete.
- Right to request restrictions. You may ask us to limit how we use or disclose your information for treatment, payment, or operations. We are not required to agree to every request.
- Right to request confidential communications. You may ask that we contact you in a particular way or at a different location.
- Right to an accounting of disclosures. You may ask for a list of certain disclosures made of your health information.
- Right to a paper copy of this notice. You may request a paper copy of this notice at any time, even if you agreed to receive it electronically.
- Right to file a complaint. If you believe your privacy rights have been violated, you may file a complaint with the practice or with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be retaliated against for filing a complaint.
The full written notice
This page is a plain-English summary. The complete written Notice of Privacy Practices is available at the office upon request.
Call (425) 637-2340 or write to Kutsy's Medical Practice, 1750 112th Ave NE, Suite D160, Bellevue, WA 98004. This notice may be revised, and any revised notice will be available at the office and on this page.